Tina Felix
Bradenton,FL
Summary
Proficient at account managing payers and value-added resellers (VARS). Strong product knowledge, provider enrollment, RCM, and excellent customer service skills, committed to supporting customers. Communicate regularly with customers, conducting training and resolving issues. Manage projects, ensuring all deliverables met. Coordinated provider enrollments with payers (Commercial, Medicaid, Medicare, Tricare). Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy, skilled in troubleshooting and resolving errors, performing quality assurance audits and training support staff to enhance processes. Excellent communication, planning and problem-solving skills. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
27
27
years of professional experience
Work History
EDI Senior Account Representative / VAR Project Manager
Athenahealth
Watertown, MA
02.2004 - 02.2023
- Conducted project management, provider enrollment and fifty payers to create, train, and answer queries on claims, remit, eligibility, enrollment and systems set processes.
- Conducted complete revenue cycle management of payers, building relationships through regular monthly calls and identifying changes to mandates or new enrollment forms that would affect client submissions, while ensuring compliance and limiting customer revenue disruption
- Facilitated and managed enrollment between clearinghouse, its customers, various trading partners and new trading partner connections
- Met with VARS during all phases of installation, ensuring smooth implementation, including tracking incoming contracts, enrollment confirmations, completing websites / databases set up, claim / remit / eligibility routes set up, training on how to use products, and attending quarterly meetings to review and resolve issues as well as discuss and forecast sales.
- Created and upgraded online enrollment forms on Adobe DC Pro, creating and collecting payer enrollment forms, adding to database which made it easier for customers to access and complete.
- Serviced cloud queue client questions, rejections etc., responding to customer responding and resolving issues in timely manner
- Resolved complex issues, including working with client unable to collect over $2M in revenue due to user error by conducting re-training over four-month period which resulted in $2M being secured.
- Project managed set projects every year that contributed to process improvements.
- Collaborated with other clearinghouses, signing trading partner agreements to ensure legally permitted to work with their payers.
- Proactively identified any mandated changes with vendors or insurance companies then planned resources required to meet project goals and objectives.
- Achieved project deadlines by coordinating cross-functional teams and third-party vendors to manage performance.
- Provided detailed technical and operational direction in project challenges, consistently meeting deliverables according to deadlines.
- Scheduled and facilitated meetings between project stakeholders to discuss deliverables, schedules and conflicts.
- Facilitated and managed EDI enrollment for hundreds of providers through EDI clearinghouse with third party vendors and insurance companies.
- Addressed customer issues with enrollment and their transactions to mitigate dissatisfaction by employing timely and on-point solutions.
- Understanding of eCommerce/EDI, their contracts, transaction types through EDI clearinghouse.
- Adhered to company policies, procedures and directives regarding standards of workplace behavior in completing job duties and assignments.
- Resolved problems with high-profile customers to maintain relationships and increase return customer base.
- Collaborated cross-functionally with teams nationally to maintain consistent message and experience.
- Collaborated with upper management to implement continuous improvements and exceed team goals.
Practice Supervisor
Fletcher Allen Healthcare, Cardiac Rehab
South Burlington, VT
01.2003 - 01.2004
- Managed daily operations of clinical sites, including support functions, patient access, scheduling (office, OR, procedure room, ancillary testing), insurance pre-certification, referral management, resource utilization, transcription, charge capture, service quality, and clinical site staffing.
- Provided outstanding support to entire staff which helped improve process flow and boosted efficiency.
- Supervised team of 20 office personnel.
- Addressed and remedied all patient or team member issues.
- Developed policies and procedures for effective practice management.
- Assessed processes and procedures, complying with OSHA, PHI and HIPAA regulations.
- Managed daily practice operations to optimize appointment scheduling, patient records management and billing functions.
- Liaised with other healthcare professionals to develop comprehensive patient care plans and provide highest quality of care.
- Established and maintained effective communication with staff, physicians and community organizations to promote high quality patient care.
Office Manager
Dr. Dara J. Chira
Burlington, VT
01.2001 - 01.2003
- Exercised leadership capabilities by successfully motivating and inspiring others.
- Completed paperwork, recognizing discrepancies and promptly addressing for resolution.
- Applied effective time management techniques to meet tight deadlines.
- Organized and detail-oriented with strong work ethic.
- Identified issues, analyzed information and provided solutions to problems.
- Proven ability to develop and implement creative solutions to complex problems.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Managed time efficiently in order to complete all tasks within deadlines.
- Managed over 50 calls per day as well as contract analysis.
Account Receivables Specialist
Malletts Bay Chiropractic
Colchester, VT
01.2000 - 01.2001
- Reconciled daily AR ledger and verified proper posting.
- Verified discrepancies and resolved clients' billing issues
- Prepared bills receivable, invoices, and bank deposits.
- Posted customer payments by recording cash, checks, and credit card transactions.
- Posted revenues by verifying and entering transactions from lock box and local deposits.
- Updated aging reports based on daily audits.
- Processed incoming payments in accordance with established financial policies.
- Effectively communicated with clients about payment needs and kept updated, detailed and accurate ledgers.
- Implemented new accounting processes to decrease spending and work flow downtime.
- Entered figures using 10-key calculator to compute data quickly.
- Generated invoices upon receipt of billing information and tracked collection progress.
Ophthalmic Technician
David S. Chase
Burlington, VT
01.1999 - 01.2000
- Used Lensometer to measure and record lens power of existing prescriptive spectacles.
- Explained pre- and post-operative procedures to patients and carefully reviewed surgical plans.
- Measured and recorded visual acuity and color vision testing.
- Instilled anesthetic drops and assisted in laser treatments and minor procedures.
- Triaged phone calls from patients and outside contacts and handled in order of importance.
- Promoted positive and smooth patient flow throughout facility, encouraging more efficient operations and boosting patient satisfaction.
- Directed patients to exam rooms for initial evaluations and intake to aide physicians with carrying out efficient appointments.
- Recorded patient history to help ophthalmologists determine diagnoses and treatment plans.
- Managed 20-30 patients each day.
Vision Center Manager
Walmart
Williston, VT
01.1996 - 01.2000
- Boosted team engagement and workplace satisfaction using managerial and motivational skills.
- Interacted with customers to help determine or suggest best products to meet eye wear needs and achieve desired look.
- Enforced HR policies and procedures to continually meet customer expectations and promote store productivity.
- Monitored general store systems, inventory databases and operations to quickly identify and resolve issues or concerns.
- Explained prescriptions, optical terminology and products to customers.
- Oversaw optician apprentice program to teach upcoming professionals valuable skills with real-world applications.
- Supervised and managed opticians using feedback, constructive conversations and leading daily activities on sales floor.
- Recorded measurements, adjusted eye wear and made changes based on customer feedback.
- Set aggressive targets for employees to drive company success and strengthen motivation.
- Maintained professional demeanor by staying calm when addressing unhappy or angry customers.
- Opened and closed location and monitored shift changes to uphold successful operations strategies and maximize business success.
- Defined clear targets and objectives and communicated to other team members.
- Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement.
- Established team priorities, maintained schedules and monitored performance.
- Increased sales to 60%.
- Managed over 40 calls per day.
- Next in line for Regional Supervisor.
Education
High School Diploma -
06.1985
Skills
- TECHNCIAL SKILLS
- Microsoft Word, Excel, PowerPoint, In-house databases, Ecommerce applications, Ecommerce website set up, Eligibility set up, Vantive, Siebel, Service Cloud, Teams, Apple software, EDI Enrollment with payers, Change Healthcare Vision Suite/Enrollment, Availity, Provider enrollment, Claim/Remit/Eligibility/HIPPA and Acrobat Adobe Professional
- Referral management
- Practice management
- Relationship building and retention
- Team Building
- Patient education and counseling
- Project oversight
- Profit improvements
- Training and mentoring
Timeline
EDI Senior Account Representative / VAR Project Manager - Athenahealth
02.2004 - 02.2023
Practice Supervisor - Fletcher Allen Healthcare, Cardiac Rehab
01.2003 - 01.2004
Office Manager - Dr. Dara J. Chira
01.2001 - 01.2003
Account Receivables Specialist - Malletts Bay Chiropractic
01.2000 - 01.2001
Ophthalmic Technician - David S. Chase
01.1999 - 01.2000
Vision Center Manager - Walmart
01.1996 - 01.2000
Essex Educational Center - High School Diploma,